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g <br /> rN <br /> i LOT LINE ADJUSTMENT <br /> I € SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> - :adya ?e¢ �.. <br /> : ir �rt i3 LCtlTIIORITIifi SfGJVATURESs$ E ?i 9 sus <br /> � i 3 x °.D „des s=d 9 •.. '� s_; s r� r �w 4 4 n � t N � � = �;€i c <br />{ _� ��"��:ONLY;ThfE.OWNER�,OF TN,E:.PROPER�IY i7f7 AN AU7"HOR�ED AGRtI1T MAY FILF ANS A�P�,fCA7"IDN� � '`� <br /> i <br /> t, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> I from any claim, action or proceeding against the Owner/Agent's project. <br /> i7 I, further, certify under�penalty of perjury that I am(check one): <br /> �y( Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> i involved in this application, or <br /> 13 Legal agent(attach proof of the owner's consent to the application) of the owner of the property(s) <br /> involved in this application and have been authorized to file on their behalf, and that the foregoing <br />[ application statements are true and correct to the best of my knowledge and belief. <br /> Print Name: David C: Silva Signature: Date: <br /> Print Name: Signature: Date.- <br /> Print <br /> ate.Print Name: I[ Signature: Date: <br /> Print Name: [I Signature: Date.- <br /> Print <br /> ate.Print Name: �` Signature: Date: <br /> I� <br /> h II <br /> i� <br /> .s <br /> i <br /> 3 <br /> :i <br /> . i <br /> i. <br /> ii <br /> �I <br /> it <br /> �I <br />